DENTAL HYGIENE

Document Sample
DENTAL HYGIENE Powered By Docstoc
					DENTAL HYGIENE
     Application
         &
 Information Packet
  University of Arkansas for Medical Sciences
    College of Health Related Professions
        Department of Dental Hygiene
       4301 W. Markham Street, #609
             Little Rock, AR 72205
                 (501) 686- 5734
               (501) 686-8519 fax
     www.uams.edu/chrp/dentalhygiene
                  revised 3/2011
                                      UAMS Department of Dental Hygiene
                                                       PROGRAM INFORMATION



THE DENTAL HYGIENE PROGRAM
The dental hygiene program is in the Department of Dental Hygiene which is part of the College
of Health Related Professions (CHRP) at the University of Arkansas for Medical Sciences
(UAMS). The program has two educational sites: Little Rock on the UAMS campus and a distant
site on the campus of Arkansas State University Mountain Home (ASUMH). Dental hygiene
students at the distant site in Mountain Home are enrolled as UAMS students and receive the
didactic (classroom) portion of the curriculum via interactive video and Web-supported courses
from UAMS. UAMS faculty members in Mountain Home provide laboratory and clinical
instruction. The Mountain Home site receives significant financial support from the UAMS Area
Health Education Center-North Central (AHEC-NC). Applicants may apply for either or both
program sites; however applicants who are permanent residents of the following 10 counties
served by the AHEC-NC are given first consideration in admission to the Mountain Home:
Baxter, Cleburne, Fulton, Independence, Izard, Marion, Searcy, Sharp, Stone, and Van Buren.
The Department enrolls one class at each of the two program sites each fall.

CURRICULUM & DEGREE OPTIONS
The UAMS Department of Dental Hygiene offers both Associate and Bachelor of Science
degrees. Graduates with either degree are qualified to apply for state, regional, and national
examinations required for licensure.

Prerequisite Courses
The program requires 34 SC (semester credits) of prerequisite course work to be completed prior
to enrolling in the dental hygiene program. At the time of application (deadline: March 1st), all
prerequisite course work does not have to be completed (see minimal qualification for
application); however, official transcripts documenting successful completion of all program
prerequisite courses must be received prior to enrolling in the dental hygiene program in August.
Students are responsible for requesting official transcripts be sent directly to the CHRP registrar
prior to fall enrollment.

When selecting courses to fulfill the prerequisite course requirements for the dental hygiene
program, please be advised that the final determination of the suitability of prerequisite course
work lies with the dental hygiene program. If there is any question about a course being accepted
as a program prerequisite, please call the department at (501) 686-5734 for verification.




                                                1
All applicants, regardless of degree option, must successfully complete the following
prerequisite courses prior to enrolling in the dental hygiene program:

                Prerequisite Course Work                                      Semester Credits
                Chemistry                                                            4
                Biology                                                              4
                Microbiology                                                         3
                College Algebra                                                      3
                Computer Science                                                     3
                U.S. History or National Government                                  3
                English Composition                                                  6
                Psychology                                                           3
                Sociology                                                            3
                Speech Communication                                                 2
                                                            TOTAL                 34 SC
          Science courses that are 7 years or older at the time that the applicant would be enrolling in the dental
          hygiene program cannot be accepted.
          Applicants must successfully complete at least two (2) of the three (3) science prerequisite courses by
          the March 1st application deadline to be considered for the dental hygiene program.
          Applicants must successfully complete no less than 18 semester credits by the March 1 st deadline to be
          considered for the dental hygiene program



Professional Curriculum
The dental hygiene program consists of 68 SC distributed over two (2) academic years (two fall
and two spring semesters plus the intervening summer session). All students enrolled in the
dental hygiene program, regardless of degree option, must complete the following 68 sc of
professional course work:
       Dental Hygiene Curriculum                    SC              Dental Hygiene Curriculum                     SC

   DHY 2311     Bio-Chemistry                        3       DHY 3145       Dental Hygiene Clinic-                1
   DHY 2312     Dental Hygiene Theory                3     Summer 3246
                                                              DHY           Local Anesthesia                      2
   DHY 2413     DH Instrumentation                   4       DHY 3531       Dental Hygiene Clinic II              5
   DHY 2314     Anatomy & Physiology I               3       DHY 3332       Pharmacology                          3
   DHY 2215     Oral Anatomy                         2       DHY 3344       Community Dentistry                   3
   DHY 2216     Oral Embryology/                     1       DHY 3334       Pathology                             3
Histology2217
   DHY          Dental Radiography I                 2        DHY 3335      Periodontology                        3
   DHY 2521     Dental Hygiene Clinic I              5        DHY 3541      Dental Hygiene Clinic III             5
   DHY 2322     Oral Medicine                        3        DHY 3342      Mgmt of Pts with Special              3
   DHY 2223     Dental Radiography II                2        DHY
                                                           Needs 3343       Practice Management                   3
   DHY 2425     Anatomy & Physiology II              4        DHY 3233      Nutrition                             2
   DHY 2327     Dental Materials                     3
                                                                                          TOTAL                68 SC




                                                      2
BS Degree Option
To receive a BS degree, an additional 24 SC of course work must be completed prior to
graduation from the dental hygiene program and may be taken prior to enrolling or concurrent
with enrollment in the dental hygiene program. These additional 24 SC include 12 SC of general
education course work plus 12 SC of upper-division (junior/senior) course work beyond the
dental hygiene curriculum. Please be advised, students enrolled at the distant site in Mountain
Home are not eligible for the AS degree; therefore, must complete all requirements for the BS
degree prior to completing the dental hygiene program.

Students electing to receive the BS degree must complete the following additional 24 semester
credits prior to graduating from the dental hygiene program:

           BS Degree Course Work                                     Semester Credits
           History of Civilization                                          6
           Fine Arts                                                        3
           Humanities                                                       3
           Electives (upper level)                                         12
           TOTAL                                                         24 SC

Additional information on the dental hygiene program including the mission statement,
educational philosophy, and professional competencies can be found at
www.uams.edu/chrp/dentalhygiene.
           TOTAL

MINIMUM QUALIFICATIONS FOR APPLICATION
The mission of the Department of Dental Hygiene is to provide high quality educational
opportunities for qualified students to prepare them as graduates to assume and maintain the role
of ethical, competent, and progressive professional practitioners; therefore, admission to the
UAMS Dental Hygiene Program is selective. To qualify for consideration for admission to the
dental hygiene program, the applicant must have met or exceeded the following minimum
qualifications. Meeting the minimal criteria for application does not guarantee admission to the
program.

     2.75 cumulative grade point average
     2.75 prerequisite grade point average
     20 composite ACT score
     20 hours of dental office observation
     Completion of a minimum of 18 SC of the prerequisite course work by the application
      deadline
     Completion of a minimum of two of the three science (chemistry, biology, microbiology)
      prerequisite courses by the application deadline. Please be advised, credit for prerequisite
      course work in biology, chemistry, and microbiology that is completed more than seven
      (7) years before the date of anticipated entry into the dental hygiene program will be
      disallowed.



                                                 3
Applicants who are not United States citizens or permanent resident aliens or for whom English
is not their native language must meet additional admission requirements. Please contact the
CHRP Admissions Office at (501) 686-5730 for more information.

In select cases, applicants may apply for academic forgiveness. Applicants are strongly advised
to consult the Admission/Academic Information section of the College’s handbook which can be
found at http://www.uams.edu/chrp/catalog.

The dental hygiene program accepts all qualified Arkansas residents before accepting out-of-
state residents.

APPLICATION PROCESS
To begin the admission process, please submit the following materials by March 1st. Application
materials received after the deadline will not be considered. Please do not send letters of
recommendation. They are not required for admission and are not considered.

   1. CHRP Undergraduate Application for Admission and Fee. The application form is
      attached and can also be found on the CHRP Web page at www.uams.edu/chrp.
      Applications are accepted at any time during the year. Applicants are encouraged to apply
      early as this allows the College and Department to assist applicants with monitoring the
      receipt of all application materials by the application deadline.

   2. Official Transcripts for all college course work from each university attended through the
      fall semester prior to application. This includes courses that are not program
      prerequisites. Transcripts must be sent directly from the institution and may not be
      forwarded or delivered by the applicant. Request official transcripts be sent to:

                     UAMS College of Health Related Professions
                     4301 W. Markham Street #619,
                     Little Rock, Arkansas 72205

   3. ACT Score (on your high school transcript and/or an official ACT score report).
      Transcripts and/or ACT score reports must be sent directly from your high school or
      ACT. The score may not be forwarded or delivered by the applicant. The program will
      use the highest composite ACT score achieved.

   4. Professional Observation Form from a dentist or dental hygienist evaluating at least 20
      hours of observation. Additional copies of the form may be made if observing in multiple
      offices. This form is attached and can also be found on the department’s Web page at
      www.uams.edu/chrp/dentalhygiene.




                                               4
CLASS SELECTION
The admission criteria are weighted as follows:
          Prerequisite GPA (35%)
          ACT Composite (30%)
          Cumulative GPA (20%).
          Interview (15%)

Using prerequisite course GPAs, ACT composite scores, and cumulative GPAs, applicants are
ranked. The most qualified applicants will be invited for an interview. Interviews are held in
early April. A class of thirty-two (32) students is typically selected for the Little Rock site, while
the ASUMH site admits five (5) students each year (fall semester). Applicants selected for
enrollment will receive notification in early May.

TYPICAL PROGRAM SCHEDULE
The UAMS dental hygiene program is a full-time, weekday commitment. The program at both
locations follows the same general schedule. Classes, laboratory sessions, and clinical sessions
are schedule Monday through Friday during the hours of 8am and 5pm. The Department does not
offer evening classes. Portions of courses are Web-assisted, but at the present time, the
Department does not offer any totally on-line courses. The program ascribes to a very strict
attendance policy, and attendance is taken at every course/clinic session.

PROGRESSION & GRADUATION
A grade of “C” or better in all pre-clinical and clinical courses is required for continuation in the
program. Students must achieve and maintain a minimum program GPA of 2.00. If a student
achieves less than a 2.00 program GPA in the first semester of the dental hygiene program, the
student must raise the program GPA to/above a 2.00 by the completion of the second semester to
continue in the dental hygiene program. If a student’s program GPA drops below a 2.00 after the
2nd semester in the program, the student will not be allowed to continue in or graduate from the
dental hygiene program. Students who are dismissed from the program for academic reasons or
withdraw by their own decision and wish to be considered for readmission for a subsequent
semester must reapply as new applicants, adhering to all policies and requirements in effect at
the time of their reapplication.

LICENSURE
To apply for licensure as a dental hygienist in the state of Arkansas, one must be a graduate of a
dental hygiene program accredited by the American Dental Association, Commission on Dental
Accreditation (UAMS is accredited). In the last semester of the program, students will take the
Southern Regional Testing Agency (SRTA) clinical board examination, the National Board
Dental Hygiene Examination, and the Arkansas dental jurisprudence examination (dental laws of
the state). Upon successful completion of the dental hygiene program, the three examinations
listed above, and proof of CPR certification, the graduate may apply to the Arkansas State Board
of Dental Examiners for licensure as a dental hygienist in the state of Arkansas. Licensure
requirements for other states may vary.




                                                  5
PROGRAM COSTS
An estimated expense sheet is attached and is also available on the Department’s Web page at
www.uams.edu/chrp/dentalhygiene. Applicants requiring financial assistance are encouraged to
apply for Federal Financial Aid in early spring by completing the “Free Application for Federal
Student Aid” (FAFSA) at www.fafsa.ed.gov. UAMS Student Financial Services can assist
students with the challenges of paying for college. They can be reached at (501) 686-6128 or at
www.uams.edu/studentfinancialservices.

UAMS students are required to show proof of health insurance coverage each semester. For
those who need health coverage, insurance is available through UAMS Student Activities and
Housing; however, students may obtain health insurance from any insurance company. For more
information about student health insurance, please contact UAMS Student Activities and
Housing at (501) 686- 5850 or http://www.uams.edu/studentlife/student_housing.asp.


INFORMATION SESSIONS
Applicants are highly encouraged to attend an Information Session for Prospective Students.
The department conducts these sessions on the second Friday in October, November, December,
and January from 1:30—3:00 p.m. While attendance is not required for admission to the
program, the session will provide you the opportunity to learn more about the profession,
prerequisite and professional course work, application process, employment opportunities in the
field, and other relevant information. The information sessions are transmitted via interactive
video to the campus of Arkansas State University-Mountain Home.

Applicants for the Little Rock program location may call Ms. Gloria Johnson at (501) 686-5734
or e-mail at JohnsonGloriaA@uams for more information.

Applicants for the Mountain Home program location may call Ms. Ruth Quick at (870) 508-6302
or e-mail at requick@uams.edu for more information.




                                              6
                                    UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
                                      COLLEGE OF HEALTH RELATED PROFESSIONS
                                          DEPARTMENT OF DENTAL HYGIENE
                                    ESTIMATED STUDENT EXPENSE SHEET FOR 2011-2012


                                                 FIRST SEMESTER (JUNIOR YEAR)
Tuition Fee - Arkansas Resident (18 hours) ....................................................................................... $ 4,122.00*
Textbooks & Syllabi (approximation) ................................................................................................              750.00
Instrument Kit (purchased from dental supply company) ..................................................................                        2,000.00
Magnification Loupes …………………………………………………………………………………                                                                                              800.00
Dentsply Cavitron……………………………………………………………………………………… 850.00
Scrubs and Lab Jackets (2 sets) (ordered at department orientation) …………………………………                                                                 130.00
Blood Pressure Cuff/Stethoscope ......................................................................................................             55.00
Student Membership Fee, American Dental Hygienists’ Association………………………………… 100.00
Student Liability Insurance…………………………………………………………………………….                                                                                          91.45
Laboratory Fee ...............................................................................................................................    125.00
Student Health Fee…………………………………………………………………………………….                                                                                                79.90
Student Clinic Fee .................................................................................................. …………………..                    63.00
Technology Fee………………………………………………………………………………………                                                                                                    46.60
Health Insurance (unless otherwise insured)                                                                                             to be determined**


                                                              SECOND SEMESTER
Tuition Fee - Arkansas Resident (17 hours) ....................................................................................... $ 3,893.00*
Textbooks & Syllabi ...........................................................................................................................     450.00
Instrument Kit (purchased from dental supply company) ..................................................................                          1,425.00
Laboratory Fee ...............................................................................................................................      125.00
Student Health Fee…………………………………………………………………………………….                                                                                                  79.90
Student Clinic Fee .................................................................................................. …………………..                      63.00
Technology Fee………………………………………………………………………………………                                                                                                      46.60
Anatomical (skull) rental……………………………………………………………………………..                                                                                             13.39
Health Insurance (unless otherwise insured)                                                                                                 to be determined**


                                                          SUMMER SEMESTER
Tuition Fee - Arkansas Resident (3 hours) ......................................................................................... $            687.00*
Textbook & Course Syllabi ................................................................................................................       125.00
Laboratory Fee ...............................................................................................................................   125.00


                                                THIRD SEMESTER (SENIOR YEAR)
Tuition Fee - Arkansas Resident (17 hours) ...................................................................................... $ 3,893.00*
Textbooks & Syllabi ...........................................................................................................................     450.00
Instrument Kit (purchased from dental supply company) ..................................................................                            750.00
Student Membership fee, American Dental Hygienists’ Association…………………………………                                                                        100.00
Student Liability Insurance…………………………………………………………………………….                                                                                            91.45
Laboratory Fee ...............................................................................................................................      125.00
Student Health Fee…………………………………………………………………………………….                                                                                                  79.90
Student Clinic Fee .................................................................................................. …………………..                      63.00
Technology Fee………………………………………………………………………………………                                                                                                      46.60
Health Insurance (unless otherwise insured)                                                                                                 to be determined**




                                                                                 7
                                                              FOURTH SEMESTER
Tuition Fee - Arkansas Resident (13 hours) ...................................................................................... $ 2,977.00*
Regional and National Board Examination Fees ................................................................................                     1,450.00
Laboratory Fee ...............................................................................................................................      125.00
Textbooks & Syllabi ...........................................................................................................................     250.00
Dental Hygiene Pin ………………………………………………………………………………….                                                                                                  50.00
Student Health Fee…………………………………………………………………………………….                                                                                                  79.90
Student Clinic Fee .................................................................................................. …………………..                      63.00
Technology Fee………………………………………………………………………………………                                                                                                      46.60
Graduation Fee…………………………………………………………………………… ................                                                                                         84.00
Health Insurance (unless otherwise insured)                                                                                                to be determined**


*NOTE: Tuition for 2011-2012 is $229 per semester credit hour (Arkansas resident) and $524 (nonresident). Fees
are subject to change without notification. ** Information on student health insurance plans is available at
http://www.uams.edu/studentlife/student_housing.asp
For financial aid information, call the UAMS Financial Aid Office at (501) 686-5454




                                                                              8
             Registered Dental Hygienist
       Dental hygienists are licensed oral health professionals who focus
             on preventing and treating oral diseases—to protect teeth
                and gums as well as protect the patients' total health.


The "RDH" Designation
"RDH" means “Registered Dental Hygienist.” The RDH credential identifies a dental hygienist
as a licensed oral health professional. State licensure requirements typically require that a dental
hygienist must graduate from a nationally-accredited dental hygiene education program,
successfully pass a national written examination and a state or regional clinical examination.

Education
Dental hygienists are graduates of accredited dental hygiene education programs in colleges and
universities, and must take written and clinical examinations before they are allowed to practice.
In addition to treating patients directly, dental hygienists also work as educators, researchers, and
administrators. At UAMS, dental hygiene graduates have two degree options: an Associate of
Science or a Bachelor of Science

Scope of Practice
Each state has its own specific regulations, and the range of services performed by dental
hygienists varies from one state to another. As part of dental hygiene services, dental hygienists
may:
       perform oral health care assessments that include reviewing patients' health history,
       dental charting, oral cancer screening, and taking and recording blood pressure;
       expose, process, and interpret dental X-rays;
       remove plaque and calculus (tartar)—soft and hard deposits—from above and below the
       gum line;
       apply cavity-preventive agents, such as fluorides and sealants, to the teeth;
       teach patients proper oral hygiene techniques to maintain healthy teeth and gums;
       counsel patients about plaque control and developing individualized at-home oral hygiene
       programs; and
       counsel patients on the importance of good nutrition for maintaining optimal oral health.
       In Arkansas, hygienists can also administer & monitor nitrous oxide/oxygen conscious
       sedation and administer local anesthesia.

Employment Opportunities
Dental hygienists can work as clinicians, educators, researchers, administrators, managers,
preventive program developers, consumer advocates, sales and marketing managers, editors, and
consultants. Clinical dental hygienists may work in a variety of health care settings such as
private dental offices, schools, public health clinics, hospitals, managed care organizations,
correctional institutions, and nursing homes.




                                                  9
Job Outlook
Employment of dental hygienists is expected to grow much faster than average for all
occupations through 2014, ranking among the fastest growing occupations, in response to
increasing demand for dental care and the greater utilization of hygienists to perform services
previously performed by dentists. Job prospects are expected to remain excellent. Population
growth and greater retention of natural teeth will stimulate demand for dental hygienists. Older
dentists, who have been less likely to employ dental hygienists, are leaving the occupation and
will be replaced by recent graduates, who are more likely to employ one or even two hygienists.
In addition, as dentists’ workloads increase, they are expected to hire more hygienists to perform
preventive dental care, such as cleaning, so that they may devote their own time to more
profitable procedures.

Earnings
The national median hourly earnings of dental hygienists is approximately $36.00. Earnings
vary greatly by geographic location, employment setting, and years of experience. Dental
hygienists may be paid on an hourly, daily, salary, or commission basis. A four-day work week
is very common in the dental profession. The average starting salary for a new graduate in
Arkansas is approximately $60,000-$65,000 (4-day work week). Benefits vary substantially by
practice setting and may be contingent upon full-time employment. Dental hygienists who work
for school systems, public health agencies, the Federal Government, or State agencies usually
have substantial benefits.

How Can I Get More Information about RDHs?
Please contact the American Dental Hygienists' Association - the largest national organization
representing the professional interests of the more than 120,000 licensed dental hygienists
nationwide at www.adha.org.

How Can I Get More Information about the UAMS Dental Hygiene Program?
Please check the UAMS Dental Hygiene web page at www.uams.edu/chrp/dentalhygiene. You
may request an information packet by visiting the website or by calling (501) 686-5730. For
more information, please call the UAMS Dental Hygiene Administrative Office at (510) 686-
5734.




                                                10
                        University of Arkansas for Medical Sciences
                              Department of Dental Hygiene

                        DENTAL OFFICE OBSERVATION FORM


Dental Hygiene Applicant: _____________________________________________________

Reference Name: _____________________________________________________________
      Address: ______________________________________________________________
      City/State/Zip: _________________________________________________________
      Telephone: ____________________________________________________________

Capacity in which you have known the applicant (e.g.: dentist or dental hygienist, etc.) We
ask that the applicant does not observe in the dental office of a family member.
______________________________________________________________________________

Professional Reference: How many hours did this applicant observe/work? ________________

Dates: From _______________________ to _________________________


Please rate the applicant’s performance in terms of the following qualities -√ all that apply.
                                          Superior       Good     Average       Fair        Poor
Sense of responsibility
Punctuality
Dependability
Personal appearance
Ability to work without supervision
Interpersonal relations with fellow
workers
Interpersonal relations with
patients/clients

Briefly, describe your impression of the seriousness of purpose and professional attitude of
the applicant in their choice of career as a dental hygienist. Please use the back of this
form if needed.




_____________________________________________                    _______________________
            Signature of Reference                                     Date

Mail to: College of Health Related Professions, 4301 West Markham Street, Slot 619, Little
Rock, AR 72205

                                              11
                 CHRP UNDERGRADUATE APPLICATION FOR ADMISSION
                                  COLLEGE OF HEALTH RELATED PROFESSIONS
                                UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES

Return this form and a non-refundable application fee to: CHRP Admissions Office, 4301 West Markham, #619, Little Rock, AR
72205. The application fee is $20.00 for the first program and $10.00 for each additional program. Call the Office of Student
Affairs for the latest information. Telephone: (501) 686-5730.

                                     All sections must be completed to process the application.

                                                PERSONAL INFORMATION

PLEASE PRINT                                                                             Date of Birth: Month/Day/Year

Social Security Number                  -         -                                                   /              /

Legal Name: Last/First/Middle

Other Names Under Which Transcripts Might Appear:

Birthplace                                                        Citizenship

U.S. State of Legal Residence                                     Native Language

Reg. No. (If Permanent Resident Alien*)                           Visa Type (If Non-Resident Alien*)


CURRENT MAILING ADDRESS: Street/City/State/Zip

                                                                                                County/Parish

Home Phone (           )                                               Work Phone (         )

If less than six (6) months, indicate previous address:


PERMANENT MAILING ADDRESS: Street/City/State/Zip

                                                                                                County/Parish

Home Phone (           )                                     E-mail Address


Have you ever been convicted of a felony?              Yes        No     If Yes, please attach a separate sheet with an explanation.

FEDERAL AND STATE REPORTS REQUIRE THE FOLLOWING INFORMATION:

    Male           Female                             Are you Hispanic/Latino?        Yes        No

    Please select one or more of the following:

             American Indian or Alaska Native                               Asian                         Black or African American

             Native Hawaiian or Other Pacific Islander                      White

*Non-resident aliens and permanent resident aliens or immigrants must provide proof of visa type with application.
                                                                 135
                                                 ACADEMIC INFORMATION

CHRP PROGRAM FOR WHICH YOU ARE APPLYING (CHECK ALL THAT ARE APPLICABLE):

         Cytotechnology                                                         Nuclear Medicine Imaging Sciences
         Dental Hygiene                                                         Ophthalmic Technologies (Ophthalmic Medical Technology)
                 Little Rock          Mountain Home                                                         must have earned 39 hours of Radiologic
                                                                                Radiation Therapy (StudentsSciences course work to apply for this program)
                                                                                                    Imaging
         Diagnostic Medical Sonography                                          Radiologic Imaging Sciences (Indicate 1st, 2nd, 3rd preference)
                 Little Rock                                                           Fayetteville                          Texarkana
                 Texarkana                                                             Little Rock
                 Degree Completion (Already ARDMS Certified)                    Respiratory Care (Indicate 1st and 2nd preference)
         Emergency Medical Sciences                                                    Little Rock                           Batesville
                 EMT                  Paramedic                                        Texarkana
         Health Information Management (Medical Record Tech)                    Note: Check one of the following for Respiratory Care:
                 Full-Time            Part-Time                                                Traditional Degree Program
         Medical Dosimetry                                                                     Three-year Program Option
         Medical Technology                                                                    RRT to BS
                 Traditional Degree Program                                     Surgical Technology
                 MLT-MT               MT-Fstrk


Semester you wish to enroll:                       Fall                       Spring                        Summer

Year you wish to enroll:                              Have you ever applied to CHRP before?                           Yes                   No

DEGREE/CERTIFICATE SOUGHT (CHECK ONE):

         Certificate                 Associate of Science                       Bachelor of Science                       Advanced Certificate

ARE YOU ATTENDING COLLEGE NOW:                                 Yes             No        If Yes, where?

EDUCATIONAL INSTITUTIONS ATTENDED--List in Chronological Order (Last Institution First) All Colleges, Universities, or Other Post
Educational Institutions Attended.
                    Name of Institution                          Dates Attended            Credits Earned          Credit       Degrees/Certificates
                   (Do Not Abbreviate)                                                     Semester (S) or         System         Earned (if any)
                                                                                          Quarter (Q) System       (Circle
                                                                                                                    One)
                                                                                                                      S
                                                                                                                     Q
                                                                                                                      S
                                                                                                                     Q
                                                                                                                      S
                                                                                                                     Q
                                                                                                                     S
                                                                                                                     Q
                                                                                                                     S
                                                                                                                     Q

Return completed application and have each educational institution you attended send one official transcript to the address listed on the opposite
side of this application. Transcripts issued to students are NOT acceptable. NOTE: Some departments/programs do not require high school
transcripts (refer to latest CHRP catalog).
I hereby affirm that all information supplied on this form is complete and accurate. It is my understanding that I shall not be considered for admission
to the University of Arkansas for Medical Sciences until I have submitted all credentials specified by the College and Department or Program. I
understand that withholding information requested or giving false information will make me ineligible for participation in the program.


SIGNED                                                                                           DATE
                                                                            136

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:10
posted:8/18/2011
language:English
pages:14